Bullying Report Form

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Reporting bullying or harassing behavior is the first step toward making our schools a safe place for everyone (this includes cyberbullying). Please report bullying if you are experiencing it, or witness it in school, on the bus, at school events, or online.

Use the following form to report bullying, which includes incidents of cyberbullying. It will be submitted directly to the administrative staff in the appropriate school. Reports are held in the strictest of confidence.

Whether you are a witness or victim in the case, we want to thank you for helping us maintain a positive and safe school environment for all of our students. (All names provided are kept confidential)

Select Today's Date *

YYYY

Select a School *

In order to address this occurrence in a timely manner, please choose a school from the dropdown.

Date Occurred/Location *

When did the bullying and/or cyberbullying occur? Please tell us the date it happened in mm/dd/yyyy format.

Name of Bully(ies) *

Name of Victim(s) *

Description *

Describe what happened as clearly as possible with as many details as you can remember.

Were there any witnesses? *

If yes, please list their names, if you know it.

Submit

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This form was created inside of Delsea Regional HS District. Report Abuse

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